We have reached that point in the year when we are taking stock of the things we have to be grateful for as well as the things we resolve to change. On the thankful side, according to an annual survey of substance use among high school students, 17.5 percent of 12th-graders admitted to being intoxicated with alcohol in the past 30 days, down significantly from 26 percent in 2013. Less than 14 percent said they had partaken in binge drinking, compared to more than 31 percent in 1998. And fewer students are using opioids.

Adding to the encouraging news, only 3.6 percent of high school seniors reported smoking cigarettes daily, compared to 22.4 percent 20 years ago. This seems to align with adult trends. According to Centers for Disease Control and Prevention findings, cigarette smoking by U.S. adults has declined from 20.9 percent in 2005 to 15.5 percent in 2016. This amounts to less than half of what it was in 1964. Accordingly, cigarette sales have been falling as well. In 2017, they were down 3.5 percent from the year before.

“Everything is pointed in the right direction,” K. Michael Cummings, of the tobacco research program at Medical University of South Carolina, told the Associated Press this past June. Included in that assessment were falling cigarette sales as well as other indicators.

Boy, did he have that wrong. It took a strongly worded statement from former Surgeon General Vivek Murthy earlier this month to put the smoking threat into perspective, singling out e-cigarettes as a public health risk to the nation’s youth. In the weeks that followed, current Surgeon General Jerome Adams expressed a more pointed view on the same subject. He called the situation “epidemic” and issued a call to take immediate action to protect the health of our nation’s young people.

According to the Monitoring the Future survey, which the University of Michigan conducts annually, “vaping” – the practice of inhaling and exhaling the vapor produced by an electronic cigarette – became dramatically more popular among high school students between 2017 and 2018. In fact, it was the biggest one-year spike of any kind in the 44 years this annual survey has been conducted. This one-year increase was twice as large as the previous record in vaping by 12th-graders. Among 10th-graders, vaping also climbed at a record rate. The findings are similar to startling figures released by the CDC last month. The agency found a 78 percent increase in e-cigarette use by teens in just one year.

Instead of burning tobacco like traditional cigarettes, e-cigarettes heat up a fluid containing nicotine, generating a vapor laced with the potent drug. While many believe the devices are safer than traditional tobacco cigarettes, having fewer contaminants, they are far from harmless. The vapor produced by e-cigarettes delivers very high levels of nicotine. Study after study shows that a large number of teens do not realize they are inhaling highly addictive nicotine when they vape.

The aerosol that users inhale and exhale from e-cigarettes can potentially expose both themselves and bystanders to other harmful substances, Adams recently explained to NBC News. They include heavy metals, volatile organic compounds and ultrafine particles that can be inhaled deeply into the lungs.

Such concerns are secondary to the main fear: nicotine. It is the ingredient most commonly found in vaping liquids. A major draw in getting teens to try vaping is the accessibility of sweetly flavored products. This does not mean the products are nicotine-free – far from it. Juul is the biggest and most successful brand name in vaping. According to an NPR report, a typical Juul cartridge contains about as much nicotine as a pack of 20 regular cigarettes.

Nicotine is one of the most addictive substances people consume. It is rarely credited as such. According to the American Cancer Society, it is the reason why it can be harder to quit smoking than to stop using cocaine or opiates such as heroin.

While e-cigarettes may have the potential to reduce health risk for current adult smokers transitioning from cigarettes, health experts point out that they pose different threats to teens and adolescents than to adults. Studies also show that using nicotine can affect the development of a young person’s brain, including their learning, memory and attention.

Even more troubling is the fact that an alarming number of teens are being hooked on this potent drug. As a result, current research shows that youth who vape are four times more likely to smoke cigarettes. Experts are concerned that the high nicotine content of vape products may be addicting a new generation of tobacco users.

Even in a world of declining use, cigarette smoking causes about 1 of every 5 deaths in the United States each year. According to CDC statistics, life expectancy for smokers is at least 10 years shorter than for nonsmokers.

If you are not worried by the above findings, then you can start now.

Altria, the leading U.S. cigarette manufacturer – parent company of Philip Morris – recently announced it is making a $12.8 billion investment in leading e-cigarette maker Juul and plans to aggressively help promote the e-cigarette brand.

I will have more thoughts on this next week. In the meantime, let us start with a New Year’s resolution to put a stop to this affront to the health of our nation and the exploitation of young people – all to make a buck.